NPI | 1861492381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 1570) |
Additional Taxonomies | 152W00000X Optometrist (Licence: NC NC1570) |
Enumeration Date | 2005-07-27 |
Last Update Date | 2022-05-04 |